Fetal and Neonatal Edition Archives of Disease in Childhood

Neonatal necrotising enterocolitis (NEC) affects 1-2% of admissions to most neonatal units and is the commonest surgical emergency in the newborn. Premature infants with additional medical problems account for most cases but about 10% are term infants with a recognised risk factor such as congenital heart disease.' 2 NEC usually responds to intensive medical treatment, which includes cessation of feeding, gastrointestinal decompression, correction of hypovolaemia, coagulopathy and acidosis, broad spectrum antibiotics, ventilatory support if required, and parenteral nutrition. Between 30 and 50%/o of patients develop complications requiring surgery. 14 There is little consensus on either the indications for or the timing and type of surgery.